The Year in Science: Medicine 1997

Tobacco Row

This was a difficult year for the tobacco industry. Not only did it agree to what some hailed as a landmark settlement designed to cut smoking rates and bring nicotine under tighter federal regulation, but top tobacco executives admitted in public that smoking was harmful and habit-forming. Among them was Steven Goldstone, chairman of RJR Nabisco, owner of R. J. Reynolds Tobacco Company, who in August was reported to have said, I have always believed that smoking plays a part in causing lung cancer. What that role is, I don’t know, but I do believe it. His remarks occurred in Florida in connection with one of a wave of tobacco-related lawsuits. At least 40 state attorneys general have sued the industry—and most joined the settlement negotiations—for money to treat tobacco-related disease.

Adding to the industry’s problems, then, were new revelations about just how deadly smoking can be—to nonsmokers and children. A ten-year, carefully controlled investigation whose results were reported this past year found that women who are constantly exposed to secondhand smoke, at work or at home, are almost twice as likely as others to have a heart attack. And even women who are only occasionally exposed experience a 58 percent increase in risk, according to the study’s lead author, epidemiologist Ichiro Kawachi of the Harvard School of Public Health.

Another alarming report hinted that smoking-related damage may occur even before birth. In a paper published in the February issue of the Journal of the National Cancer Institute, researchers led by epidemiologist Bu-Tian Ji of Columbia found that children of men who smoked for five years before a child’s conception were nearly three times more likely to develop leukemia and more than four times more likely to develop lymphoma. The researchers suspect the problem could be caused by smoking-related genetic damage to the fathers’ sperm.

Concern for children’s health was a driving force behind the settlement negotiations. One stated goal is a ban on advertising aimed at kids; others include cutting the amount of nicotine in tobacco and creating antismoking campaigns. The settlement is currently held up in Congress. Meanwhile, it remains to be seen whether the rising chorus of blame will help drive people—especially children—away from tobacco. The appeal of the noxious leaf remains strong and it manifests itself in surprising ways—the cigar fad being one. A 1997 survey found that more than a quarter of all American high school students smoked at least one cigar this past year.